Quantitative Analysis of Narrative Discourse by Autistic Adults of Underrepresented Genders

Community brief Why is this an important issue?How a person tells stories can help clinicians diagnose autism. Only a few research studies have explored how autistic adults tell stories. Most autism research is based on cisgender boys and men. Nonbinary people, transgender people, and cisgender women are underrepresented in research. Research with non-autistic adults has shown gender differences in how people tell stories. When cisgender women, nonbinary people, and transgender people seek autism diagnosis in adulthood, they might be misdiagnosed if clinicians do not know how autistic people of their gender might tell stories. What was the purpose of this study?The purpose of this study was to find out whether autistic people of different genders tell stories in different ways. What did the researchers do?We recruited autistic nonbinary people, transgender people, and cisgender women and men. On a Zoom call with a researcher, each participant told two stories about a picture and two stories about their experiences. We measured how long the stories were, how long their sentences were, how many different words people used, how many words they used about emotions and thoughts, and how often they said um and uh. We made three sets of comparisons: (1) cisgender men compared with all other participants; (2) participants assigned male at birth compared with participants assigned female at birth; (3) self-identified women, nonbinary people, and men compared with each other. We used a high standard for statistical significance because we made so many comparisons. What were the results of the study? 1. Stories told by cisgender men were the same as the stories told by everyone else, on all the measures. Stories told by participants assigned female at birth and participants assigned male at birth were the same on all the measures. 2. When women, nonbinary people, and men were compared with each other, no group differences were statistically significant using our high standard. Despite this, there were two interesting patterns: Women used each different word more times in their stories than men did. Women used more words about emotions and thoughts than men did. None of the other comparisons showed gender differences. What do these findings add to what was already known?These findings suggest that autistic women may be more likely to talk about emotions and thoughts than autistic men. Clinicians evaluating women for autism should not necessarily expect autistic women to talk about the same things that they expect autistic men to talk about. In general, autistic speakers of diverse genders had more similarities than differences, and it did not matter how we grouped their genders. What are potential weaknesses in the study?The group of participants was small, and the gender groups were uneven. The participants were mostly white and highly educated. Repeating the study with a larger, more diverse group of people could help researchers to understand similarities and differences in autistic communication better. How will these findings help autistic adults now or in the future?These findings can help autistic adults by teaching clinicians who diagnose autism about ways that women and nonbinary people tell stories. The findings challenge stereotypes about autistic people that are based on cisgender men. Background: Narrative production is an important part of the diagnostic process for autism. Most existing research on narrative production by autistic people has focused on cisgender men and boys. Members of other genders (i.e., nonbinary people, transgender men, and trans and cisgender women) are underrepresented in the research literature. Research with non-autistic adults consistently reports gender differences in narrative production. When adults whose genders are underrepresented seek autism diagnosis as adults, they may be misdiagnosed due to misconceptions about autistic communication that are based on cisgender male speakers.Methods: Twenty autistic adults of various genders each told four narratives: two based on a picture and two about their personal experiences. Dependent variables measured narrative length, grammatical complexity, vocabulary diversity, filled pauses, and internal state terms. Researchers used nonparametric statistics to compare groups of (1) cisgender men and all other participants, (2) participants assigned male at birth and those assigned female, and (3) self-identified women, nonbinary people, and men.Results: Women used significantly less diverse vocabulary than men. Women used more terms to refer to internal states than both nonbinary people and men, but this finding was not significant after correction for multiple comparisons. All other comparisons were not statistically significant.Conclusions: Autistic narrators of diverse genders have more linguistic similarities than differences. Autistic women may be more likely to talk about emotions and other internal states than autistic men. Gender-based expectations for spoken communication about internal states should be carefully reconsidered. More research is necessary to determine whether the results of this small study will generalize to larger samples of autistic people whose genders are currently underrepresented in the research literature.